A bill signed into law on April 1 directs the Centers for Medicare & Medicaid Services (CMS) to postpone post-payment audits of the two-midnight rule until after March 31, 2015. In the meantime, CMS has implemented pre-payment probe and educate reviews to determine if hospitals are in compliance.
When the Medicare Administrative Contractors (MACs) conduct probe and educate prepayment audits of compliance with the two-midnight rule, inadequate documentation and lack of one or more of the components of certification are major reasons for the denials, according to Ralph Wuebker, MD, MBA, chief medical officer for Executive Health Resources, a Newtown Square, PA, healthcare consulting firm.
A readmission reduction collaborative of San Francisco Bay-area hospitals and their post-acute partners has reduced hospital readmissions by 20% among participating hospitals, preventing more than 4,000 readmissions.
